Janssen-de Ruijter Elisabeth A W, Mulder Eva A, Vermunt Jeroen K, van Nieuwenhuizen Chijs
GGzE Centre for Child & Adolescent Psychiatry, PO BOX 909 (DP 8001), 5600 AX Eindhoven, The Netherlands.
Scientific Center for Care & Welfare (Tranzo), Tilburg University, Tilburg, The Netherlands.
Child Adolesc Psychiatry Ment Health. 2017 Dec 19;11:63. doi: 10.1186/s13034-017-0204-1. eCollection 2017.
The development of delinquent behaviour is largely determined by the presence of (multiple) risk factors. It is essential to focus on the patterns of co-occurring risk factors in different subgroups in order to better understand disruptive behaviour.
The aim of this study was to examine whether subgroups could be identified to obtain more insight into the patterns of co-occurring risk factors in a population of adolescents in residential care. Based on the results of prior studies, at least one subgroup with many risk factors in multiple domains and one subgroup with primarily risk factors in a single domain were expected.
The structured assessment of violence risk in youth and the juvenile forensic profile were used to operationalize eleven risk factors in four domains: individual, family, peer and school. Data from 270 male adolescents admitted to a hospital for youth forensic psychiatry and orthopsychiatry in the Netherlands were available. Latent class analysis was used to identify subgroups and significant differences between the subgroups were examined in more detail.
Based on the fit statistics and the clinical interpretability, the four-class model was chosen. The four classes had different patterns of co-occurring risk factors, and differed in the included external variables such as psychopathology and criminal behaviour.
Two groups were found with many risk factors in multiple domains and two groups with fewer (but still several) risk factors in single domains. This study shed light on the complexity of disruptive behaviour, providing a better insight into the patterns of co-occurring risk factors in a heterogeneous population of adolescents with major psychiatric problems admitted to residential care.
犯罪行为的发展很大程度上取决于（多种）风险因素的存在。关注不同亚组中共存风险因素的模式对于更好地理解破坏性行为至关重要。
本研究的目的是检验是否可以识别出亚组，以便更深入地了解住院护理青少年群体中共存风险因素的模式。基于先前研究的结果，预计至少有一个亚组在多个领域存在许多风险因素，另一个亚组主要在单个领域存在风险因素。
使用青少年暴力风险的结构化评估和青少年法医概况来将四个领域（个人、家庭、同伴和学校）中的11个风险因素进行操作化。可获取来自荷兰一家青少年法医精神病学和儿童精神病学医院收治的270名男性青少年的数据。采用潜在类别分析来识别亚组，并更详细地检查亚组之间的显著差异。
基于拟合统计量和临床可解释性，选择了四类模型。这四类具有不同的共存风险因素模式，并且在所纳入的外部变量（如精神病理学和犯罪行为）方面也有所不同。
发现两组在多个领域存在许多风险因素，两组在单个领域存在较少（但仍有几个）风险因素。本研究揭示了破坏性行为的复杂性，为入住住院护理机构的患有严重精神问题的异质青少年群体中共存风险因素的模式提供了更好的见解。
